The Spleen and Its Disorders

Chapter 72 The Spleen and Its Disorders



Nathan T. Connell, Susan B. Shurin, Fred J. Schiffman



Management of Splenic Cysts


A 37-year-old woman with no past medical history comes in for evaluation of early satiety and left shoulder pain. She reports that she feels full after only a few bites of any meal and sometimes becomes nauseated and vomits. Physical examination is remarkable for an enlarged nontender spleen. Imaging shows a large splenic cyst.



• Many conditions can lead to cyst formation in the spleen, including parasitic infections, trauma, hemangiomas, and polycystic kidney disease.


• Asymptomatic nonparasitic cysts may be observed with careful attention and development of a plan for intervention should they become symptomatic, rupture, or become infected.


• Symptomatic cysts may require percutaneous drainage with radiologic guidance or sometimes surgical procedures, including partial or total splenectomy.*


• Parasitic cysts should be treated in consultation with infectious disease specialists because the particular parasitic infection, radiologic appearance, and patient comorbidities will guide choice of therapies.


image

Figure 72-1 RED BLOOD CELL FINDINGS IN HYPOSPLENISM.


A, Red blood cells with Howell-Jolly bodies. B, Nucleated red blood cell. C, Cells with Pappenheimer bodies. Red blood cells with Howell-Jolly bodies are seen in patients with hyposplenism. The cytoplasmic inclusions (A)

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Jun 12, 2016 | Posted by in HEMATOLOGY | Comments Off on The Spleen and Its Disorders

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